A novel missense mutation in the AIRE gene underlying autoimmune polyglandular syndrome type 1

The immune regulator gene AIRE plays an essential role in the establishment of immune tolerance and the prevention of autoimmunity. This transcription factor plays a critical role in promoting self-tolerance in the thymus by regulating the expression of a large number of self-antigens that share the common feature of being tissue-restricted in their expression pattern in the periphery. Dysfunction of AIRE in humans causes a rare disease, autoimmune polyglandular syndrome type 1 (APS1), characterized by an autoimmune response against peripheral tissues, particularly endocrine tissues. Although a few dominant mutations have been described, the inactivation of AIRE is usually caused by recessive mutations. Recent data suggests that alterations in AIRE function contribute not only to APS1 but also to more common forms of autoimmune disease. Here, we present a previously unreported missense mutation (NM_000383.2:c.260 T > C) in exon 2 of the AIRE gene, predicted to cause the substitution (p.(Leu87Pro)) in the CARD domain of the AIRE protein. When inherited in conjunction with another dysfunctional AIRE allele, this mutation was associated with immune dysregulation in a pediatric patient. The presence of hypergammaglobulinemia, malabsorption syndrome, ectodermal dysplasia, mucocutaneous candidiasis, vitiligo, and hypothyroidism as well as the presence of multiple autoantibodies allowed us to confirm an APS1 diagnosis.

Exploring Scoring Function Space: Developing Computational Models for Drug Discovery

BACKGROUND

The idea of scoring function space established a systems-level approach to address the development of models to predict the affinity of drug molecules by those interested in drug discovery.

OBJECTIVE

Our goal here is to review the concept of scoring function space and how to explore it to develop machine learning models to address protein-ligand binding affinity.

METHOD

We searched the articles available in PubMed related to the scoring function space. We also utilized crystallographic structures found in the protein data bank (PDB) to represent the protein space.

RESULTS

The application of systems-level approaches to address receptor-drug interactions allows us to have a holistic view of the process of drug discovery. The scoring function space adds flexibility to the process since it makes it possible to see drug discovery as a relationship involving mathematical spaces.

CONCLUSION

The application of the concept of scoring function space has provided us with an integrated view of drug discovery methods. This concept is useful during drug discovery, where we see the process as a computational search of the scoring function space to find an adequate model to predict receptor-drug binding affinity.

Convergent Evolution in SARS-CoV-2 Spike Creates a Variant Soup from Which New COVID-19 Waves Emerge

The first 2 years of the COVID-19 pandemic were mainly characterized by recurrent mutations of SARS-CoV-2 Spike protein at residues K417, L452, E484, N501 and P681 emerging independently across different variants of concern (Alpha, Beta, Gamma, and Delta). Such homoplasy is a marker of convergent evolution. Since Spring 2022 and the third year of the pandemic, with the advent of Omicron and its sublineages, convergent evolution has led to the observation of different lineages acquiring an additional group of mutations at different amino acid residues, namely R346, K444, N450, N460, F486, F490, Q493, and S494. Mutations at these residues have become increasingly prevalent during Summer and Autumn 2022, with combinations showing increased fitness. The most likely reason for this convergence is the selective pressure exerted by previous infection- or vaccine-elicited immunity. Such accelerated evolution has caused failure of all anti-Spike monoclonal antibodies, including bebtelovimab and cilgavimab. While we are learning how fast coronaviruses can mutate and recombine, we should reconsider opportunities for economically sustainable escape-proof combination therapies, and refocus antibody-mediated therapeutic efforts on polyclonal preparations that are less likely to allow for viral immune escape.

COVID-19 mitigation by digital contact tracing and contact prevention (app-based social exposure warnings)

A plethora of measures are being combined in the attempt to reduce SARS-CoV-2 spread. Due to its sustainability, contact tracing is one of the most frequently applied interventions worldwide, albeit with mixed results. We evaluate the performance of digital contact tracing for different infection detection rates and response time delays. We also introduce and analyze a novel strategy we call contact prevention, which emits high exposure warnings to smartphone users according to Bluetooth-based contact counting. We model the effect of both strategies on transmission dynamics in SERIA, an agent-based simulation platform that implements population-dependent statistical distributions. Results show that contact prevention remains effective in scenarios with high diagnostic/response time delays and low infection detection rates, which greatly impair the effect of traditional contact tracing strategies. Contact prevention could play a significant role in pandemic mitigation, especially in developing countries where diagnostic and tracing capabilities are inadequate. Contact prevention could thus sustainably reduce the propagation of respiratory viruses while relying on available technology, respecting data privacy, and most importantly, promoting community-based awareness and social responsibility. Depending on infection detection and app adoption rates, applying a combination of digital contact tracing and contact prevention could reduce pandemic-related mortality by 20-56%.

Vinardo: A Scoring Function Based on Autodock Vina Improves Scoring, Docking, and Virtual Screening

Autodock Vina is a very popular, and highly cited, open source docking program. Here we present a scoring function which we call Vinardo (Vina RaDii Optimized). Vinardo is based on Vina, and was trained through a novel approach, on state of the art datasets. We show that the traditional approach to train empirical scoring functions, using linear regression to optimize the correlation of predicted and experimental binding affinities, does not result in a function with optimal docking capabilities. On the other hand, a combination of scoring, minimization, and re-docking on carefully curated training datasets allowed us to develop a simplified scoring function with optimum docking performance. This article provides an overview of the development of the Vinardo scoring function, highlights its differences with Vina, and compares the performance of the two scoring functions in scoring, docking and virtual screening applications. Vinardo outperforms Vina in all tests performed, for all datasets analyzed. The Vinardo scoring function is available as an option within Smina, a fork of Vina, which is freely available under the GNU Public License v2.0 from http://smina.sf.net. Precompiled binaries, source code, documentation and a tutorial for using Smina to run the Vinardo scoring function are available at the same address.

Short length transmembrane domains having voluminous exoplasmic halves determine retention of Type II membrane proteins in the Golgi complex

It is still unclear why some proteins that travel along the secretory pathway are retained in the Golgi complex while others follow their way to the plasma membrane (PM). Recent bioinformatic analyses on a large number of single spanning membrane proteins support the hypothesis that specific features of the Trans-Membrane Domain (TMD) are relevant to the sorting of these proteins to particular organelles. Here we experimentally test this hypothesis for Golgi and PM proteins. Using the Golgi SNARE Sft1 and the PM SNARE Sso1 from Saccharomyces cerevisiae as model proteins, we modified the length of their TMDs and the volume of their exoplasmic hemi-TMD, and determined their subcellular localization both in yeast and mammalian cells. We found that short TMDs with voluminous exoplasmic hemi-TMDs confer Golgi membrane residence, while TMDs having less voluminous exoplasmic hemi-TMDs, being either short or long, confer PM residence to these proteins. Results indicate that the shape of the exoplasmic hemi-TMD, in addition to the length of the entire TMD, determine retention in the Golgi or exit to the PM of Type II membrane proteins.

Vacuolar protein sorting receptor in Giardia lamblia

In Giardia, lysosome-like peripheral vacuoles (PVs) need to specifically coordinate their endosomal and lysosomal functions to be able to successfully perform endocytosis, protein degradation and protein delivery, but how cargo, ligands and molecular components generate specific routes to the PVs remains poorly understood. Recently, we found that delivering membrane Cathepsin C and the soluble acid phosphatase (AcPh) to the PVs is adaptin (AP1)-dependent. However, the receptor that links AcPh and AP1 was never described. We have studied protein-binding to AcPh by using H6-tagged AcPh, and found that a membrane protein interacted with AcPh. This protein, named GlVps (for Giardia lamblia Vacuolar protein sorting), mainly localized to the ER-nuclear envelope and in some PVs, probably functioning as the sorting receptor for AcPh. The tyrosine-binding motif found in the C-terminal cytoplasmic tail domain of GlVps was essential for its exit from the endoplasmic reticulum and transport to the vacuoles, with this motif being necessary for the interaction with the medium subunit of AP1. Thus, the mechanism by which soluble proteins, such as AcPh, reach the peripheral vacuoles in Giardia appears to be very similar to the mechanism of lysosomal protein-sorting in more evolved eukaryotic cells.

Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

BACKGROUND

The aim of this study was to document the types of diseases treated by the use of medicinal plants, their main applications and also to have a report of the major diseases treated at the Hospital of San Pablo de Huacareta (Chuquisaca Bolivia).

METHODS

We conducted semi-structured interviews on the use medicinal plants with 10 local informants, and categorized the kinds of diseases treated by traditional medicine. We obtained reports of cases treated at the Hospital of Huacareta in order to compare the use frequency of traditional medicine and allopathic medicine for the treatment of recurrent diseases in the area.

RESULTS

Our survey identified 258 traditional medicine uses, spanning a total of 13 diseases categories and including 91 native and exotic plant species and one unidentified sample plant type. Gastrointestinal disorders (55%) were most frequently treated with medicinal plants, followed by afflictions of the musculoskeletal system (25%) and dermatological disorders (24%). Hospital information indicates that the most common diseases are acute respiratory infections (47%) and acute diarrheal diseases (37%). The herbal remedies were mostly used in the form of teas and decoctions. The informants used mainly native plant species, although exotic species has been introduced to the pharmacopoeia.

CONCLUSIONS

The treatment of gastrointestinal disorders is the primary objective of the medical ethnobotany of the inhabitants of Huacareta, while respiratory system diseases are mostly treated in the hospital. Looking at the data from the Hospital records we can infer that gastrointestinal disorders are among the most common diseases in the study area. For most respondents, traditional medicine is a reliable choice for the care of their illnesses. However, the preference of the population for either traditional medicine or allopathic medicine needs to be clarified in future comparative studies to obtain more convincing results. The results presented can be used as a base for subsequent work related to traditional medicine and its contribution to allopathic medicine in San Pablo de Huacareta.

Cellular and molecular biology of glycosphingolipid glycosylation

Brain tissue is characterized by its high glycosphingolipid content, particularly those containing sialic acid (gangliosides). As a result of this observation, brain tissue was a focus for studies leading to the characterization of the enzymes participating in ganglioside biosynthesis, and their participation in driving the compositional changes that occur in glycolipid expression during brain development. Later on, this focus shifted to the study of cellular aspects of the synthesis, which lead to the identification of the site of synthesis in the neuronal soma and their axonal transport toward the periphery. In this review article, we will focus in subcellular aspects of the biosynthesis of glycosphingolipid oligosaccharides, particularly the mechanisms underlying the trafficking of glycosphingolipid glycosyltransferases from the endoplasmic reticulum to the Golgi, those that promote their retention in the Golgi and those that participate in their topological organization as part of the complex membrane bound machinery for the synthesis of glycosphingolipids.

Organization of the synthesis of glycolipid oligosaccharides in the Golgi complex

Glycolipids constitute a complex family of amphipathic molecules structurally characterized by a hydrophilic mono- or oligo-saccharide moiety linked to a hydrophobic ceramide moiety. Due to their asymmetric distribution in cell membranes, exposing the saccharide moiety to the extracytoplasmic side of the cell, glycolipids participate in a variety of cell-cell and cell-ligand interactions. Here we summarize aspects of the cell biology of the stepwise synthesis of the saccharide moiety in the Golgi complex of cells from vertebrates. In particular we refer to the participant glycosyltransferases, with emphasis on their trafficking along the secretory pathway, their retention and organization in the Golgi complex membranes and their dependence on the Golgi complex ultra structural organization for proper function.

Specificity of transmembrane protein palmitoylation in yeast

Many proteins are modified after their synthesis, by the addition of a lipid molecule to one or more cysteine residues, through a thioester bond. This modification is called S-acylation, and more commonly palmitoylation. This reaction is carried out by a family of enzymes, called palmitoyltransferases (PATs), characterized by the presence of a conserved 50- aminoacids domain called “Asp-His-His-Cys- Cysteine Rich Domain” (DHHC-CRD). There are 7 members of this family in the yeast Saccharomyces cerevisiae, and each of these proteins is thought to be responsible for the palmitoylation of a subset of substrates. Substrate specificity of PATs, however, is not yet fully understood. Several yeast PATs seem to have overlapping specificity, and it has been proposed that the machinery responsible for palmitoylating peripheral membrane proteins in mammalian cells, lacks specificity altogether.

Here we investigate the specificity of transmembrane protein palmitoylation in S. cerevisiae, which is carried out predominantly by two PATs, Swf1 and Pfa4. We show that palmitoylation of transmembrane substrates requires dedicated PATs, since other yeast PATs are mostly unable to perform Swf1 or Pfa4 functions, even when overexpressed. Furthermore, we find that Swf1 is highly specific for its substrates, as it is unable to substitute for other PATs. To identify where Swf1 specificity lies, we carried out a bioinformatics survey to identify amino acids responsible for the determination of specificity or Specificity Determination Positions (SDPs) and showed experimentally, that mutation of the two best SDP candidates, A145 and K148, results in complete and partial loss of function, respectively. These residues are located within the conserved catalytic DHHC domain suggesting that it could also be involved in the determination of specificity. Finally, we show that modifying the position of the cysteines in Tlg1, a Swf1 substrate, results in lack of palmitoylation, as expected for a highly specific enzymatic reaction.

Giardia lamblia low-density lipoprotein receptor-related protein is involved in selective lipoprotein endocytosis and parasite replication

As Giardia lamblia is unable to synthesize cholesterol de novo, this steroid might be obtained from the host's intestinal milieu by endocytosis of lipoproteins. In this work, we identified a putative Giardia lamblia low-density lipoprotein receptor-related proteins (GlLRP), a type I membrane protein, which shares the substrate N-terminal binding domain and a FXNPXY-type endocytic motif with human LRPs. Expression of tagged GlLRP showed that it was localized predominantly in the endoplasmic reticulum, lysosomal-like peripheral vacuoles and plasma membrane. However, the FXNPXY-deleted GlLRP was retained at the plasma membrane suggesting that it is abnormally transported and processed. The low-density lipoprotein and chylomicrons interacted with GlLRP, with this interaction being necessary for lipoprotein internalization and cell proliferation. Finally, we show that GlLRP binds directly to the medium subunit of Giardia adaptor protein 2, indicating that receptor-mediated internalization occurs through an adaptin mechanism.

Molecular and genetic characterization of novel S-RNases from a natural population of Nicotiana alata

Self-incompatibility in the Solanaceae is mediated by S-RNase alleles expressed in the style, which confer specificity for pollen recognition. Nicotiana alata has been successfully used as an experimental model to elucidate cellular and molecular aspects of S-RNase-based self-incompatibility in Solanaceae. However, S-RNase alleles of this species have not been surveyed from natural populations and consequently the S-haplotype diversity is poorly known. Here the molecular and functional characterization of seven S-RNase candidate sequences, identified from a natural population of N. alata, are reported. Six of these candidates, S ( 5 ), S ( 27 ), S ( 70 ), S ( 75 ), S ( 107 ), and S ( 210 ), showed plant-specific amplification in the natural population and style-specific expression, which increased gradually during bud maturation, consistent with the reported S-RNase expression. In contrast, the S ( 63 ) ribonuclease was present in all plants examined and was ubiquitously expressed in different organs and bud developmental stages. Genetic segregation analysis demonstrated that S ( 27 ), S ( 70 ), S ( 75 ), S ( 107 ), and S ( 210 ) alleles were fully functional novel S-RNases, while S ( 5 ) and S ( 63 ) resulted to be non-S-RNases, although with a clearly distinct pattern of expression. These results reveal the importance of performing functional analysis in studies of S-RNase allelic diversity. Comparative phylogenetic analysis of six species of Solanaceae showed that N. alata S-RNases were included in eight transgeneric S-lineages. Phylogenetic pattern obtained from the inclusion of the novel S-RNase alleles confirms that N. alata represents a broad sample of the allelic variation at the S-locus of the Solanaceae.

Corpus callosum abnormalities and the controversy about the candidate genes located in 1q44

Submicroscopic deletions of 1q44-qter cause severe mental retardation, profound growth retardation, microcephaly and corpus callosum hypo/agenesis in most patients. At least 3 intervals in 1q44 have been described as critical regions containing genes leading to corpus callosum abnormalities. In this report we describe a patient with a de novo small interstitial 1q44 deletion of 1,152 kb detected with 44K oligonucleotide array-CGH (44K Agilent Technologies) and a mild phenotype lacking corpus callosum abnormalities. The first deleted oligonucleotide was located at 242.638 Mb (within the ADSS gene), and the last deleted oligonucleotide at 243.791 Mb (within the KIF26B gene). The clinical and molecular findings of the patient here reported remain consistent with a role for the AKT3 or ZNF238 genes in corpus callosum development.

Rare chromosomal complement of trisomy 21 in a boy conceived by IVF and cryopreservation

This report describes a case of mosaic Down syndrome due to an unusual karyotype in a patient conceived by assisted reproductive techniques and cryopreservation. The chromosomal complement consists of two different cell lines, one predominantly trisomic with a derivative chromosome due to a Robertsonian translocation (21;21) and another carrying a ring chromosome 21. The present work analyses the different mechanisms that could have led to mosaicism.

Submicroscopic duplication of the Wolf-Hirschhorn critical region with a 4p terminal deletion

Chromosomal rearrangements in the short arm of chromosome 4 can result in 2 different clinical entities: Wolf-Hirschhorn syndrome (WHS), characterized by severe growth delay, mental retardation, microcephaly, 'Greek helmet' facies, and closure defects, or partial 4p trisomy, associated with multiple congenital anomalies, mental retardation, and facial dysmorphisms. We present clinical and laboratory findings in a patient who showed a small duplication in 4p16.3 associated with a subtle terminal deletion in the same chromosomal region. GTG-banding analyses, multiplex ligation-dependent probe amplification analyses, and studies by array-based comparative genomic hybridization were performed. The results of the analyses revealed a de novo 1.3 Mb deletion of the terminal 4p and a 1.1 Mb duplication in our patient, encompassing the WHS critical region. Interestingly, this unusual duplication/deletion rearrangement results in an intermediate phenotype that shares characteristics of the WHS and the 4p trisomy syndrome. The use of novel technologies in the genetic diagnosis leads to the description of new clinical syndromes; there is a growing list of microduplication syndromes. Therefore, we propose that overexpression of candidate genes in WHS (WHSC1, WHSC2 and LETM1) due to a duplication causes a clinical entity different to both the WHS and 4p trisomy syndrome.

Characterization of SNAREs determines the absence of a typical Golgi apparatus in the ancient eukaryote Giardia lamblia

Giardia is a eukaryotic protozoal parasite with unusual characteristics, such as the absence of a morphologically evident Golgi apparatus. Although both constitutive and regulated pathways for protein secretion are evident in Giardia, little is known about the mechanisms involved in vesicular docking and fusion. In higher eukaryotes, soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNAREs) of the vesicle-associated membrane protein and syntaxin families play essential roles in these processes. In this work we identified and characterized genes for 17 SNAREs in Giardia to define the minimal set of subcellular organelles present during growth and encystation, in particular the presence or not of a Golgi apparatus. Expression and localization of all Giardia SNAREs demonstrate their presence in distinct subcellular compartments, which may represent the extent of the endomembrane system in eukaryotes. Remarkably, Giardia SNAREs, homologous to Golgi SNAREs from other organisms, do not allow the detection of a typical Golgi apparatus in either proliferating or differentiating trophozoites. However, some features of the Golgi, such as the packaging and sorting function, seem to be performed by the endoplasmic reticulum and/or the nuclear envelope. Moreover, depletion of individual genes demonstrated that several SNAREs are essential for viability, whereas others are dispensable. Thus, Giardia requires a smaller number of SNAREs compared with other eukaryotes to accomplish all of the vesicle trafficking events that are critical for the growth and differentiation of this important human pathogen.

Active and passive mechanisms drive secretory granule biogenesis during differentiation of the intestinal parasite Giardia lamblia

The parasitic protozoan Giardia lamblia undergoes important changes to survive outside the intestine of its host by differentiating into infective cysts. During encystation, three cyst wall proteins (CWPs) are specifically expressed and concentrated within encystation-specific secretory vesicles (ESVs). ESVs are electron-dense secretory granules that transport CWPs before exocytosis and extracellular polymerization into a rigid cyst wall. Because secretory granules form at the trans-Golgi in higher eukaryotes and because Giardia lacks an identifiable Golgi apparatus, the aim of this work was to investigate the molecular basis of secretory granule formation in Giardia by examining the role of CWPs in this process. Although CWP1, CWP2, and CWP3 are structurally similar in their 26-kDa leucine-rich overlapping region, CWP2 is distinguished by the presence of a 13-kDa C-terminal basic extension. In non-encysting trophozoites, expression of different CWP chimeras showed that the CWP2 basic extension is necessary for biogenesis of ESVs, which occurs in a compartment derived from the endoplasmic reticulum. Nevertheless, the CWP2 basic extension per se is insufficient to trigger ESV formation, indicating that other domains in CWPs are also required. We found that CWP2 is a key regulator of ESV formation by acting as an aggregation factor for CWP1 and CWP3 through interactions mediated by its conserved region. CWP2 also acts as a ligand for sorting via its C-terminal basic extension. These findings show that granule biogenesis requires complex interactions among granule components and membrane receptors.

Successful replantation following an accidental forearm amputation. Case report and review of the literature

We report a patient who suffered an accidental complete amputation of the right forearm followed by a successful replantation and comment on the indications and management of macro-replantations of the upper limbs. This is the first time that a successful surgical procedure of this nature has been performed in Bolivia, with no post-operative complications and excellent long-term functional recovery.

L-selectin expression is low on CD34+ cells from patients with chronic myeloid leukemia and interferon-a up-regulates this expression

BACKGROUND AND OBJECTIVE

Altered adhesive interaction between bone marrow (BM) stroma and progenitors in chronic myeloid leukemia (CML) may be in part caused by abnormal expression of cell adhesion molecules (CAMs) on malignant progenitor cells. Treatment of CML with interferon-a (IFN-a) re-establishes normal hemopoiesis in some patients in part by restoring normal adhesive interactions between CML progenitors and BM microenvironment, which may in turn be mediated by correcting CAM expression on progenitors.

DESIGN AND METHODS

We investigated the expression of CAMs (L-selectin, b((2))-integrin, LFA-3, ICAM-1, ICAM-3, NCAM) on purified BM CD34(+) cells from CML patients (n= 34) and healthy adults (n= 15) by flow cytometry. Modulation of L-selectin expression on CD34(+) cells from CML after in vitro treatment with IFN-a was also investigated.

RESULTS

The mean percentage of CD34(+ )cells expressing L-selectin was significantly lower in CML patients (25.4+/-12.8%) than in normal controls (68.7+/-8.3%, n=15). CD34(+)/HLA-DR(&endash;/low) and CD34(+)/ CD38(&endash;/low) co-expressing L-selectin were also significantly lower in untreated CML (27.4+/-21.5% and 39.8+/-26.7%, respectively, n=8) than in controls (61+/-17% and 83.7+/-10%, respectively, n=7). In vitro treatment with IFN-a of purified CD34(+) BM cells from untreated CML patients (n=8) induced a significant, dose and time-dependent increase in the L-selectin expression as indicated by FACS analysis.

INTERPRETATION AND CONCLUSIONS

We hypothesize that this L-selectin deficiency reflects a cell surface adhesion defect of progenitors from CML that is partially restored by in vitro IFN-a treatment. These data may help to explain the adhesive abnormalities of CML progenitors to the BM microenvironment and the in vitro restoration of adhesion capacity after IFN-a treatment.

CD7 expression on CD34+ cells from chronic myeloid leukaemia in chronic phase

Thirty-seven patients with chronic phase chronic myeloid leukaemia and fourteen healthy controls have been evaluated for lineage differentiation with immunological markers on purified bone marrow CD34 positive cells by multiparameter flow cytometry. The myeloid-associated antigen CD33 and the stem cell factor receptor (CD117, c-kit) was expressed by 82.3% and 73.5% on CP-CML patients and by 57% and 57.5% on healthy donors, respectively (P < 0.005). CD34+/CD19+ or CD34+/CD10+ B-lymphoid cell population represented 9. 1% and 10.7% of the CD34+ cells in CML whereas in normal controls this subpopulation was expressed by 27.9% and 30.4% of the CD34+ cells, respectively (P< 0.005). The T-lineage associated markers (CD7 and CD2) were detected on a minor population of CD34+ BM cells of healthy controls (mean, 3.6% and 4.6%, respectively). The CD2 positive cells represented 1.5% of the CD34+ cells in CML patients. CP-CML patients co-expressed the CD7 antigen on a mean of 32.6% of the CD34+ BM cells. Moreover, 93% of this CD34/CD7 double positive subpopulation co-expressed CD33 antigen in CML patients. Co-expression of CD7 on CD34+ cells was induced to decrease significantly after short-term in vitro culture with the differentiation-inducing agent phorbol ester (PMA) and with a combination of cytokines (stem-cell factor, interleukin-3 and granulocyte colony-stimulating factor). In conclusion, a high co-expression of CD7 antigen is demonstrated on CD34+ cells of chronic phase-chronic myeloid leukaemia patients. The loss of CD7 marker following incubation with PMA and cytokines suggests that this antigen is expressed transiently in early myeloid leukaemic CML haemopoiesis.

A prefilled injection device for outreach tetanus immunization by Bolivian traditional birth attendants

This study evaluated the performance, acceptability, and appropriateness of a new, single-use, prefilled injection device called UniJect for an outreach immunization application. Between April and June 1995, UniJect devices were used by 36 traditional birth attendants to administer tetanus toxoid injections to 2,240 pregnant women during routine, antenatal home visits in the Northern, Ichilos, and Warnes Districts of Santa Cruz, Bolivia. Because tetanus toxoid is relatively heat stable, the traditional birth attendants were able to keep the tetanus toxoid-filled UniJect devices in their homes for up to one month without refrigeration. The devices were stored, transported, and disposed of in an outreach carrier designed to reduce the risks of improper handling and disposal. Data were collected from injection recipients, traditional birth attendants, and supervisors via observation, questionnaires, and post-study interviews. The performance of the UniJect device and its acceptability among all groups was very high. The traditional birth attendants used UniJect properly and safely; there were no reports or observations of device misuse, reuse, or needle-stick. Advantages cited included the fact that the device required no assembly, offered assured sterility, and reduced vaccine wastage sometimes associated with multi-dose vials. The ability to store and transport the vaccine-filled devices without ice also greatly simplified logistics.

IL-2 effects on allogeneic and autologous transplant haemopoietic progenitors in long-term cultures

IL-2 therapy may be useful in situations with a low tumour burden, such as after autologous transplantation. However, conflicting reports about the deleterious effects of this cytokine on haemopoiesis have precluded its widespread use. To study IL-2 effects on haemopoietic transplant progenitors we established long-term cultures (Dexter-type) with cells from allogeneic marrow and marrow/peripheral blood cell infusates of autologous transplants with different concentrations of IL-2 (0-1000 IU/ml). Percentage of CD56+ cells was also determined in cultures. IL-2 induced an inhibitory effect on stroma and an increase in the percentage of CD56+ cells compared with controls. No deleterious effect either in the production of BFU-E or CFU-GM weekly or over the whole period of culture was observed. Our results suggest that IL-2 is able to induce an increase in CD56+ cells early after transplantation without a deleterious effect on long-term haemopoiesis.

[Percutaneous transvenous mitral commissurotomy with a Medi-tech balloon catheter: the initial experience and midterm follow-up]

From Jan-21-91 to Jan-8-92 we performed percutaneous transvenous mitral commissurotomy (PTCM) with a Medi-tech balloon catheter (MBC) in 41 patients bearing mitral stenosis simple o predominant. We utilized an anterograde transseptal approach in order to access the mitral valve, the procedure failed in 5 patients, in 30 of them we used double MBC and single MBC were utilized in 6 patients. Both left ventriculogram and hemodynamic parameters were taken before and after PTCM. Posterior to PTCM an important decrease appeared in the mitral transvalvular gradient from 20.6 +/- 2.7 to 2.4 +/- 1.7 mmHg (p < 0.0001) and an average pressure of pulmonary artery of 46.2 +/- 9.8 to 23.9 +/- 6 mmHg (p < 0.0001), and also the pulmonary arterial resistance from 1178.1 to 557.1 dinas/cm-5/seg. There was an important concomitant increase in mitral valvular area from 0.84 +/- 0.11 to 2.38 +/- 0.08 cm2 (p < 0.0001) and in cardiac rate from 2.7 +/- 0.7 to 2.9 +/- 0.52 L/min (p < 0.001).

COMPLICATIONS

Two female patients developed cardiac tamponade, one of them the procedure was successful, and for the other it was decided to submit her to valvular replacement. Mitral insufficiency was present in three patients; GI/IV in two of them and GII/IV angiographic in one. Another patient presented cerebral thromboembolism with complete recovery within 15 days. Short left to right shunt was detected only in 8 patients being 1.2/1 in 6 of them, 1.3/1 in one and 1.4/1 in other patient. Thirty three uncomplicated were dismissed within a maximum of 48 hours after procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

[Coronary angioplasty in the treatment of symptomatic myocardial ischemia with one vessel disease]

Our group initiated a program of coronary angioplasty (CA) in patients with symptomatic one vessel disease, or multivascular lesions with a critical "culprit" stenosis. In a 16 month period we have performed CA of 28 lesions in 25 patients (20 men) with a mean age of 54 +/- 10 years. Stable angina was diagnosed in 14 patients, unstable angina in 7, and post-myocardial infarction residual angina or stenosis in 4 patients treated with streptokinase. Successful dilatation was obtained in 23 (82.1%) of 28 stenotic segments, reducing the stenosis from 90 +/- 8% (range 70-100) to 9 +/- 12% (range 0-30; p less than 0.00001). In 4 cases with total occlusion, dilatation was not obtained, and in one case the procedure was complicated by fatal brain embolism. There were 4 complications due to coronary occlusion or spasm, all of them resolved during CA without sequelae. The 20 cases with primary success have been followed during an average of 8.6 months. In three cases (15%) restenosis was detected; two of them underwent surgery, and CA was repeated successfully in the other. Disappearance of myocardial ischemia was confirmed in 14 patients, and functional improvement in the other three. In conclusion, CA is an effective and relatively safe therapeutic alternative in different clinical forms of coronary heart disease with a single vessel stenosis, or in selected cases of multivascular lesions with a critical stenosis.

Radial bone mineral content in healthy Mexican women

Fifty healthy Mexican women from 21 to 70 years of age volunteered to undergo radial bone densitometry. The bone density in ten women per decade was assessed at two sites in the radius of the nondominant forearm; one site was the distal radius at 5 mm of separation from the ulna and the other at one-third of the distal radius. Calcium, inorganic phosphates and alkaline phosphatase were measured in serum samples and the calcium/creatinine ratio in fasting urine samples. Bone density at the distal radius was 360.6 +/- 36.2 mg/cm2, 369.8 +/- 47.9 mg/cm2 and 364.7 +/- 53.7 mg/cm2 in the 21-50 age group. There was no significant difference between these groups; the pooled value of all these samples was 365 +/- 46 mg/cm2. There was significant difference in the 51-60 age group, 290 +/- 48. mg/cm2 (p less than 0.01) and in the 61-70 age group. 277.9 +/- 49.9 mg/cm2 (p less than 0.01). Bone density at the one-third distal radius in the 21-20 age group was 696.3 +/- 60.9 mg/cm2; 31-40, 683.6 +/- 68.4 mg/cm2 and 41-50, 697.9 +/- 53.9 mg/cm2. There was no significant difference among these group; the pool of all these samples showed 692.6 +/- 59.6 mg/cm2. In the 51-60 age group it was 628.0 +/- 63.3 mg/cm2, a non significant difference. On the other hand, the density in the 61-70 group was 573.7 +/- 83.5 mg/cm2, significant (p less than 0.01) when compared to the 21-50 age group.(ABSTRACT TRUNCATED AT 250 WORDS)

The pathogenesis of corneal edema induced by Tween 80

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